Comparing cytomegalovirus prophylaxis in renal transplantation: single center experience
In: Transplant infectious disease : an official journal of the Transplantation Society, Jg. 7 (2005-09-10), Heft 2
Online
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Zugriff:
Background: Cytomegalovirus (CMV) presents a serious threat to CMV-seronegative recipients (R−), who have received an organ from a seropositive donor (D+). Objectives: We compared the effectiveness of three different prophylactic protocols in CMV D+/R− patients and reviewed data on patients who received no prophylaxis. Patients and methods: We reviewed 1137 kidney transplantations from 1995 to 2004. Of these, 147 recipients were CMV negative (D+/R−); 125 patients received CMV prophylaxis. Group I received CMV hyperimmune gammaglobulin only, group II received CMV hyperimmune gammaglobulin plus oral ganciclovir, and group III received prophylaxis with oral ganciclovir only. Results: In group I, CMV infection was observed in 31 of 53 patients (59%), and CMV disease was diagnosed in 9 (17%) during the prophylaxis. In the first year post transplant, a total of 41 of 53 patients (77.5%) had primary CMV infection. In group II, CMV infection occurred in 7 of 30 patients (23%), and CMV disease was diagnosed in only 2 (7%) during prophylaxis. In the first year post transplant, a total of 9 of 30 patients (30%) had primary CMV infection. In group III, 9 of 42 patients (21%) developed CMV infection during prophylaxis, and CMV disease was not observed. In the first year post transplant, a total of 13 of 42 patients (30%) had primary CMV infection. In contrast, all 22 CMV D+/R− patients without prophylaxis developed CMV infection (100%); CMV disease was diagnosed in 10 (45%), and 1 patient died. Conclusions: Prophylaxis with hyperimmune gammaglobulin and/or oral ganciclovir significantly reduces CMV infection and disease. Prophylaxis with ganciclovir was significantly more effective than hyperimmune gammaglobulin monoprophylaxis, and more cost effective than combined prophylaxis.
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Comparing cytomegalovirus prophylaxis in renal transplantation: single center experience
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Autor/in / Beteiligte Person: | Gerlei, Zsuzsanna ; Remport, Adam ; Kóbori, László ; Fazakas, János ; Varga, Marina ; Telkes, Gábor ; Járay, Jenő ; Péter, A. ; Hidvégi, M. ; Sulyok, B. ; Sárváry, Enikő |
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Zeitschrift: | Transplant infectious disease : an official journal of the Transplantation Society, Jg. 7 (2005-09-10), Heft 2 |
Veröffentlichung: | 2005 |
Medientyp: | unknown |
ISSN: | 1398-2273 (print) |
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